Abstract
Objective
To evaluate indications, pregnancy outcomes, and risk of adverse events following
amnioreduction procedures in singleton gestations.
Study design
Study of all amnioreduction procedures performed on singleton gestations complicated
by polyhydramnios between January 2011 and June 2018 at our tertiary and regional
referral fetal center. Clinical indications for amnioreduction procedures were categorized
as either maternal shortness of breath, perceived abdominal tightness, or preterm
uterine contractions with or without cervical change. Our primary outcome(s) of interest
were: preterm premature rupture of membranes (PPROM), placental abruption, chorioamnionitis
and/or preterm delivery, each in isolation or as a composite.
Results
Among 358 patients who underwent amnioreduction in the study period, 251 arose from
cases of twin-twin transfusion syndrome (TTTS) and 74 were singletons undergoing additional
fetal intervention procedures. Each of the remaining 33 patients underwent a median
number of one [range 1–12] amnioreductions over the antepartum interval, yielding
a total of 66 amnioreduction procedures. Among the study cohort, there were no instances
of PPROM, placental abruption, chorioamnionitis or preterm delivery within the 12 h
following the procedure but 10.6% experienced preterm delivery within 48 h of amnioreduction.
Conclusion
Our data suggests that among singleton gestations, there was a low risk for preterm
delivery in close proximity to the procedure and none experienced rupture of membranes,
placental abruption, sepsis, fetal demise or neonatal death. This data may be used
in counseling of potential candidates for amnioreduction with singleton pregnancies
and symptomatic polyhydramnios.
Keywords
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Article info
Publication history
Published online: May 19, 2019
Accepted:
May 17,
2019
Received:
April 29,
2019
Identification
Copyright
© 2019 Elsevier B.V. All rights reserved.
